You Don’t Have to Pee Your Pants When You [Fill in the Blank]

Running after your toddler on the playground, performing double unders, or sneezing should NOT lead to urinary leakage. However, 60% of people who go through childbirth experience these symptoms. And 23% who experience incontinence either stop or reduce the amount of physical activity they are performing. This should not be the case as physical activity helps with the health of your pelvic floor. It is common, but it does not have to be normal.  Urinary leakage is usually caused by a change in muscle tone or a change in how the body holds abdominal pressure with activities. Below are a few exercises and tactics that you can implement to decrease urine leakage. 

• Breath Work: A good rule of thumb is to breathe out when things are their most effortful to avoid leakage. For example, in a squat, the most effortful part of the exercise is initiating the stand up from the squat. Try exhaling at the same as you begin your rise up to decrease the pressure in your body. This can also be done when getting up from a chair, sneezing or jumping down from a step. 

• Knack Tactic: If you leak with sneezing or coughing, you can try the Knack tactic. Prior to a sneeze or cough initiate a pelvic floor squeeze. Good ways to initiate a squeeze are to think about stopping the flow of urine, lifting something up and into the vaginal canal, and/or squeezing to stop from passing gas. Just before you cough or sneeze, tighten these muscles quickly and strongly. Once you sneeze, relax these muscles. 

• Core Strength: Core exercises are crucial for maintaining pelvic floor health because a strong core provides stability and support to the pelvic organs and muscles. By strengthening the core muscle, you can indirectly strengthen the pelvic floor muscles, which play a key role in bladder and bowel control. Effective core exercises include planks, deadbugs, bridges, and reverse planks. 

• Adductor Strength: Like core strength, adductor strength is important for pelvic floor health because they help stabilize the pelvis and support its alignment. The adductors are a group of muscles located on the inner thighs that assist in maintaining pelvic stability during movements like walking, standing, and lifting. Good exercises for the adductors include Copenhagen planks, sumo squats, and lateral lunges. 

• Water Intake: Drinking additional water may sound counterintuitive, but by increasing your water intake to at least half of your bodyweight in oz, you can regulate your toileting habits and increase bladder health. Adequate hydration supports the overall health and function of these muscles, ensuring they remain elastic and responsive. Proper hydration also helps prevent constipation, a common factor contributing to pelvic floor disorders.

• Progressive Loading: Progressive loading benefits the pelvic floor by gradually increasing the intensity of exercises over time, which strengthens the muscles without overexerting them. This approach allows the pelvic floor muscles to adapt and become stronger, enhancing their ability to maintain continence. For example, if you are deadlifting or squatting 135 pounds but you continuously leak with this weight, decrease to a weight that you don’t leak at and perform your desired sets and reps. Then increase the weight as you feel stronger over a few weeks. 

Regular practice of these exercises and tactics contributes to overall pelvic floor stability and function. The goal is to gain confidence in your body and remain active or return to activity with no fear of urinary leakage. Give yourself grace and time as these muscles grow and learn how to function again!